Bring In Advocates

Consumer advocates are complaining that they are not welcome on the state board that is setting up the exchanges where uninsured individuals and small businesses will soon be able to buy health insurance coverage.

They have a point.

Starting in 2014, most Americans will be required to carry insurance. The exchanges are meant to provide a choice of affordable plans, under President Obama's health care reforms.

The state's Health Insurance Exchange Board, therefore, is making critical decisions: Can any insurer participate or will the exchange negotiate deals for consumers? Which state mandates will the exchange plans have to include (such as mental health coverage)?

Of the 14 people on this important board, only one is a consumer advocate, and she, state Health Care Advocate Vickie Veltri, is a non-voting member.

The blame for this oversight lies with the lawmakers who created the board. The legislation carefully designated exactly what kind of expertise each member had to have — health care finance, benefit plans and so on — and who would appoint which member. But it made scant mention of a consumer representative, besides the state advocate.

The exchange board, as a result, has the insurance industry covered with retired ConnectiCare CEO Mickey Herbert and two former Aetna executives. Hospitals are represented too. Other members seem chosen for political expertise, such as the longtime staffer for the Senate Democrats.

This isn't all bad. Those who know their way around insurance headquarters and the state Capitol have valuable insights and should indeed have seats at this table. But so should consumers.

Oregon requires a balance of consumer representation and health insurance experts on its board. Connecticut's lawmakers ought to amend the law to add at least one voting consumer representative, or given the health care advocate a vote. Gov. Dannel P. Malloy has indicated he'd sign such a bill.

Conflicts of interest may be hard to avoid altogether on this kind of board, given the need for insurance industry and health provider know-how. To protect the interests of individuals who desperately need affordable insurance, therefore, consumers should have a strong voice at the table and a vote.